VP, Clinical Operations

Alignment Healthcare USA; United States; On-site; USD 260,000 - 400,000; Full time

Job summary

Alignment Health seeks a visionary Vice President of Clinical Operations to lead strategic development, design, and continuous improvement of clinical programs within our value-based care framework. This role focuses on holistic patient management across the care continuum, optimizing pre-hospitalization interventions and post-acute transitions to align with corporate strategy and regulatory requirements.

The VP will oversee a large, multidisciplinary organization, instill a results-driven

Responsibilities

• Develop and execute a comprehensive clinical strategy to support medical cost management and quality performance goals.
• Design end-to-end transitional care management programs to engage high-risk patients before hospitalization and ensure safe transitions.
• Refine evidence-based clinical protocols for chronic disease management, predictive risk-stratification, and social determinants of health tracking.
• Lead cross-functional initiatives integrating clinical operations, population health, risk adjustment, and quality improvement programs.
• Evaluate and adopt emerging technologies such as AI-driven triage, decision support, remote monitoring, and telehealth to improve outcomes.
• Collaborate with primary care providers and hospitalists to ensure timely communication and achieved outcomes.

Job description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Vice President of Clinical Operations is responsible for the strategic development, design, and continuous improvement of clinical programs, interventions, and health initiatives for our value-based care (VBC) arrangements. This leader will focus heavily on the holistic management of patients across the continuum of care, specifically optimizing pre-hospitalization interventions and post-acute transitions of care to ensuring that the patient outcomes align with corporate strategy, regulatory requirements, and the organization's mission to improve member health, enhance member experience, and optimize medical cost performance.

The VP will oversee a large, multidisciplinary organization, and will instill a results-driven culture, and ensure that teams deliver measurable improvements to prevent avoidable hospitalizations, eliminate gaps in care, reduce re-admissions, to achieve desired member outcomes.

Job Profile Summary:

The Vice President of Clinical Operations is responsible for the strategic development, design, and continuous improvement of clinical programs, interventions, and health initiatives for our value-based care (VBC) arrangements. This leader will focus heavily on the holistic management of patients across the continuum of care, specifically optimizing pre-hospitalization interventions and post-acute transitions of care to ensuring that the patient outcomes align with corporate strategy, regulatory requirements, and the organization's mission to improve member health, enhance member experience, and optimize medical cost performance.

The VP will oversee a large, multidisciplinary organization, and will instill a results-driven culture, and ensure that teams deliver measurable improvements to prevent avoidable hospitalizations, eliminate gaps in care, reduce re-admissions, to achieve desired member outcomes.

Job Responsibilities:

Strategic Leadership & Program Development

• Develop and execute a comprehensive clinical strategy that supports medical cost management, quality performance (e.g., STAR ratings, HEDIS, CAHPS), and member engagement goals.
• Design end-to-end transitional care management (TCM) programs that proactively engage high-risk patients before hospitalization and safely transition them to the appropriate setting.
• Design, implement, and continuously refine evidence-based clinical protocols and interventions for chronic disease management, predictive risk-stratification, and social determinants of health (SDOH) tracking.
• Lead cross-functional initiatives integrating clinical operations, population health, risk adjustment, and quality improvement programs.
• Evaluate and recommend emerging technologies-AI-driven triage, clinical decision support, remote monitoring, and telehealth-to improve member outcomes and program efficiency.
• Collaborate effectively with primary care providers (RMOs, PCPs, SPCs) and hospitalists to ensure timely communication and feedback is received to ensure outcomes are achieved.

Clinical Program Oversight & Performance

• Oversee end-to-end lifecycle of clinical programs - from concept design through pilot, rollout, evaluation, and scaling.
• Establish program KPIs and outcomes measurement frameworks; monitor performance and ensure continuous quality improvement.
• Integrate clinical analytics and predictive modeling to identify high-impact intervention opportunities and measure ROI.
• Ensure ongoing alignment of clinical program strategies with CMS, HEDIS, CAHPS, HOS, Stars, and risk adjustment requirements with a focus on optimizing Medicare Advantage performance.
• Partner with provider networks and care management teams to enhance care coordination, reduce avoidable utilization, and improve chronic disease management.
• Ensure that the clinical operating model is executed consistently across regions, with minimal variation and maximum reliability.

Team Leadership & Culture

• Lead a large, geographically distributed team of clinicians, clinical managers, and support staff with a clear focus on execution, accountability, and results.
• Build a culture where expectations are clear; performance is monitored rigorously, and outcomes are delivered reliably.
• Develop leaders who excel in operational performance management, problem solving, and talent development.

Vendor Management

• Establish performance expectations and metrics for vendor part